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Elevated Lipoprotein(a) Level Influences Familial Hypercholesterolemia Diagnosis
Familial hypercholesterolemia (FH) and elevated lipoprotein(a) [Lp(a)] level are the most common inherited disorders of lipid metabolism. This study evaluated the impact of high Lp(a) level on accuracy Dutch Lipid Clinic Network (DLCN) criteria of heterozygous FH diagnosis. A group of 206 individual...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884002/ https://www.ncbi.nlm.nih.gov/pubmed/35225859 http://dx.doi.org/10.3390/diseases10010006 |
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author | Chubykina, Uliana V. Ezhov, Marat V. Afanasieva, Olga I. Klesareva, Elena A. Pokrovsky, Sergei N. |
author_facet | Chubykina, Uliana V. Ezhov, Marat V. Afanasieva, Olga I. Klesareva, Elena A. Pokrovsky, Sergei N. |
author_sort | Chubykina, Uliana V. |
collection | PubMed |
description | Familial hypercholesterolemia (FH) and elevated lipoprotein(a) [Lp(a)] level are the most common inherited disorders of lipid metabolism. This study evaluated the impact of high Lp(a) level on accuracy Dutch Lipid Clinic Network (DLCN) criteria of heterozygous FH diagnosis. A group of 206 individuals not receiving lipid-lowering medication with low-density lipoprotein cholesterol (LDL-C) >4.9 mmol/L was chosen from the Russian FH Registry. LDL-C corrected for Lp(a)-cholesterol was calculated as LDL-C − 0.3 × Lp(a). DLCN criteria were applied before and after adjusting LDL-C concentration. Of the 206 patients with potential FH, a total of 34 subjects (17%) were reclassified to less severe FH diagnosis, 13 subjects of them (6%) were reclassified to “unlike” FH. In accordance with Receiver Operating Characteristic curve, Lp(a) level ≥40 mg/dL was associated with FH re-diagnosing with sensitivity of 63% and specificity of 78% (area under curve = 0.7, 95% CI 0.7–0.8, p < 0.001). The reclassification was mainly observed in FH patients with Lp(a) level above 40 mg/dL, i.e., 33 (51%) with reclassified DLCN criteria points and 22 (34%) with reclassified diagnosis, compared with 21 (15%) and 15 (11%), respectively, in patients with Lp(a) level less than 40 mg/dL. Thus, LDL-C corrected for Lp(a)-cholesterol should be considered in all FH patients with Lp(a) level above 40 mg/dL for recalculating points in accordance with DLCN criteria. |
format | Online Article Text |
id | pubmed-8884002 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88840022022-03-01 Elevated Lipoprotein(a) Level Influences Familial Hypercholesterolemia Diagnosis Chubykina, Uliana V. Ezhov, Marat V. Afanasieva, Olga I. Klesareva, Elena A. Pokrovsky, Sergei N. Diseases Article Familial hypercholesterolemia (FH) and elevated lipoprotein(a) [Lp(a)] level are the most common inherited disorders of lipid metabolism. This study evaluated the impact of high Lp(a) level on accuracy Dutch Lipid Clinic Network (DLCN) criteria of heterozygous FH diagnosis. A group of 206 individuals not receiving lipid-lowering medication with low-density lipoprotein cholesterol (LDL-C) >4.9 mmol/L was chosen from the Russian FH Registry. LDL-C corrected for Lp(a)-cholesterol was calculated as LDL-C − 0.3 × Lp(a). DLCN criteria were applied before and after adjusting LDL-C concentration. Of the 206 patients with potential FH, a total of 34 subjects (17%) were reclassified to less severe FH diagnosis, 13 subjects of them (6%) were reclassified to “unlike” FH. In accordance with Receiver Operating Characteristic curve, Lp(a) level ≥40 mg/dL was associated with FH re-diagnosing with sensitivity of 63% and specificity of 78% (area under curve = 0.7, 95% CI 0.7–0.8, p < 0.001). The reclassification was mainly observed in FH patients with Lp(a) level above 40 mg/dL, i.e., 33 (51%) with reclassified DLCN criteria points and 22 (34%) with reclassified diagnosis, compared with 21 (15%) and 15 (11%), respectively, in patients with Lp(a) level less than 40 mg/dL. Thus, LDL-C corrected for Lp(a)-cholesterol should be considered in all FH patients with Lp(a) level above 40 mg/dL for recalculating points in accordance with DLCN criteria. MDPI 2022-01-18 /pmc/articles/PMC8884002/ /pubmed/35225859 http://dx.doi.org/10.3390/diseases10010006 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Chubykina, Uliana V. Ezhov, Marat V. Afanasieva, Olga I. Klesareva, Elena A. Pokrovsky, Sergei N. Elevated Lipoprotein(a) Level Influences Familial Hypercholesterolemia Diagnosis |
title | Elevated Lipoprotein(a) Level Influences Familial Hypercholesterolemia Diagnosis |
title_full | Elevated Lipoprotein(a) Level Influences Familial Hypercholesterolemia Diagnosis |
title_fullStr | Elevated Lipoprotein(a) Level Influences Familial Hypercholesterolemia Diagnosis |
title_full_unstemmed | Elevated Lipoprotein(a) Level Influences Familial Hypercholesterolemia Diagnosis |
title_short | Elevated Lipoprotein(a) Level Influences Familial Hypercholesterolemia Diagnosis |
title_sort | elevated lipoprotein(a) level influences familial hypercholesterolemia diagnosis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884002/ https://www.ncbi.nlm.nih.gov/pubmed/35225859 http://dx.doi.org/10.3390/diseases10010006 |
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